CQC report explained · a nursing home
What the CQC found at Hollyhurst
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were well managed, staff knew how to respond to abuse and incidents, medicines were handled safely, and infection control measures were in place.
- Effective?
- Good
- This key question was not inspected during this focused visit. Its rating was carried forward from the last inspection.
- Caring?
- Good
- This key question was not inspected during this focused visit. Its rating was carried forward from the last inspection.
- Responsive?
- Good
- People received personalised care, had choices about their support and activities, and were helped to communicate in ways they could understand.
- Well-led?
- Good
- Inspectors found a more positive culture, clearer management systems and better involvement of people in decisions about the service.
What inspectors found, February 2023
Rated Good; inspectors found safer, more personalised care and improved leadership, but said the large communal setting did not meet key principles.
This was an unannounced, focused inspection. Inspectors visited the home, spoke with people, relatives and staff, observed care, and checked care records, medicines, risk assessments, recruitment records and safety checks.
The home was rated Good overall. Safe, Responsive and Well-led were all rated Good. Inspectors found that risks were better managed, medicines were handled safely, people had choice and personalised care, and the culture had improved since the previous inspection.
The inspection also found that the large communal home, with more than six people living together, did not meet the principles of Right support, right care, right culture. There were still some vacant staff posts, although inspectors found enough staff on duty and improved recruitment and induction processes.
The previous overall rating was Requires Improvement and the home had been in breach of Regulation 17. Inspectors found enough improvement at this inspection and said the provider was no longer in breach.
Improved safety
Risks were assessed and reviewed with people, relatives and staff. Restrictions were monitored and staff looked for safer, less restrictive approaches.
“Risks to people's safety were well managed and systems supported timely responses.” from the report
Personalised support
Care plans included people's needs and preferences. Positive behaviour support plans had been improved and were used consistently.
“The service delivered person-centred care with people having choice and control regarding how staff met their needs.” from the report
Communication and community life
Staff used communication tools such as Makaton, picture systems and easy-read documents. People were supported to go out, pursue interests and join local activities.
“The provider understood the AIS requirements and had made sure appropriate communication tools, such as Makaton, PECS (Picture Exchange Communication System) and easy read documents were in place.” from the report
Improved culture
People and staff described a more positive atmosphere. Management had introduced development plans and gave people more ways to influence the service.
“There was a positive culture that promoted good outcomes.” from the report
Large communal setting
needs fixingInspectors said the home’s large communal environment did not meet the principles of Right support, right care, right culture. This may be important if your relative needs a smaller or more individual setting.
“The environment of a large (more than 6 people) living in one communal home does not meet the principles of Right support, right care, right culture.” from the report
Vacant staff posts
minorRecruitment and retention had improved, but there were still vacant posts. Inspectors found enough staff during the visit and used regular agency staff for consistency.
“Staff recruitment and retention was a priority in the service, as there were vacant posts.” from the report
- 01How does the large communal layout affect my relative's privacy, independence and ability to make everyday choices?
- 02How many staff vacancies are there now, and how often are agency staff used?
- 03Which parts of the previous action plan have been completed, and how will improvements be checked?
- 04How will you make sure my relative's communication method is used consistently by all staff?
- 05How are restrictions and any physical interventions reviewed and reduced where possible?
This was a focused inspection of Safe, Responsive and Well-led; Effective and Caring were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 25 February 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, December 2021
Hollyhurst was rated Requires Improvement; inspectors found delays in incident reviews and gaps in medicine records, although infection control and staffing levels were considered safe.
This was an unannounced inspection over five dates in October and November 2021. Inspectors spoke with people living at the home, relatives, staff and health professionals. They reviewed care, medicine, staffing and management records.
The home was not always safe or well-led. Serious incidents were not always reported or investigated promptly, and incidents were sometimes left for about four weeks before review. Some records for topical and when-required medicines were also missing, although these were corrected during or shortly after the inspection.
Staffing levels were judged safe, but sickness and vacancies meant staff sometimes felt stretched. Infection control arrangements were found to be suitable. Care plans and risk assessments had improved, and relatives gave positive feedback about the care.
The overall rating fell from Good at the previous inspection to Requires Improvement. The report says the provider must send an action plan, and CQC will monitor progress and return to inspect again.
Infection control
Inspectors were assured that the home had suitable arrangements for preventing and managing infections, including the use of protective equipment and visits.
“We were assured that the provider was using PPE effectively and safely.” from the report
Staff checks and staffing levels
Recruitment checks, including DBS checks, were in place. Inspectors judged staffing levels to be safe at the time of the inspection.
“Staff recruitment was undertaken in a safe and effective manner.” from the report
Improved care planning
Care plans and risk assessments had been improved and staff said they were clear and easy to follow.
“People's care records contained evidence that risks were regularly revised and updated.” from the report
Positive feedback
People and relatives gave positive feedback about living at the home, the care provided and communication with the service.
“People we spoke with were positive about living at Hollyhurst and about having their views heard.” from the report
Delayed incident reviews
seriousA serious incident was reported to CQC two months later and investigated several weeks after it happened. Other incidents and safeguarding matters could wait about four weeks for review, delaying action to reduce risks.
“The registered manager told us there was a delay in reviewing of four weeks due to their workload.” from the report
Medicine records
needs fixingSome records for topical and when-required medicines were incomplete. The home corrected this during or shortly after the inspection, but its monitoring system had not identified the gaps.
“We identified shortfalls with the recording of topical and when required medicines.” from the report
Staff sickness and vacancies
needs fixingThe home was using agency staff because of vacancies. Staff said sickness had a major effect on them and that staffing could feel very stretched.
“All staff we spoke with stated that sickness levels was having a big impact on them and that at times staffing was very stretched.” from the report
Large communal setting
needs fixingThe report says the large communal home did not meet the principles used by CQC for supporting choice, control and independence for people with a learning disability.
“The environment of a large (more than 6 people) living in one communal home does not meet the principles of Right support, right care, right culture.” from the report
- 01How are incidents and safeguarding concerns now reviewed, and how quickly are actions recorded?
- 02What checks now make sure records for topical and when-required medicines are complete?
- 03How many permanent vacancies remain, how much agency cover is being used, and how are staffing levels monitored when sickness is high?
- 04What action is being taken about the large communal living environment and people's choice, control and independence?
- 05What improvements have been made since the action plan requested by CQC, and when will these be reviewed?
This was an inspection prompted by concerns about incident management and staffing, and it rated Safe and Well-led; the other key questions were not rated in this report. This explanation was written from the published report of 8 December 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Hollyhurst
5 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- February 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2021Requires improvementSafe: Requires improvementWell-led: Requires improvement
- September 2020Inspected but not ratedSafe: Inspected but not ratedEffective: Inspected but not ratedCaring: Inspected but not ratedResponsive: Inspected but not ratedWell-led: Inspected but not rated
- July 2019Goodstayed GoodSafe: GoodResponsive: Requires improvementWell-led: Good
- April 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- September 2013
Registered with the Care Quality Commission on 3 September 2013.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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36 live-in carers within about an hour of Darlington
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £970 to £1,230 a week. 35 can care for a couple. 11 years' experience on average.
“Petty introduced herself to Mum every time she was caring for her and responded very quickly to Mum if she was distressed in the night.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.